Bulimia

Introduction

Bulimia nervosa is an eating disorder and mental health condition.

People who have bulimia try to control their weight by severely restricting the amount of food they eat, then binge eating and purging the food from their body by making themselves vomit or using laxatives.

As with other eating disorders, bulimia nervosa can be associated with:

Binge eating and purging

Eating disorders are often associated with an abnormal attitude towards food or body image.

Everyone has their own eating habits – for example, people with a food intolerance need to avoid eating certain foods to stay healthy. However, people suffering from eating disorders tend to use their eating habits and behaviours to cope with emotional distress, and often have an abnormal or unrealistic fear of food, calories and being fat.

Because of this fear, people with bulimia nervosa tend to restrict their food intake. This results in periods of excessive eating and loss of control (binge eating), after which they make themselves vomit or use laxatives (purging). They purge themselves because they fear that the binging will cause them to gain weight, and usually feel guilty and ashamed of their behaviour. This is why these behaviours are usually done in secret.

Such binge-purge cycles can be triggered by hunger or stress, or are a way to cope with emotional anxiety.

Warning signs

Signs of bulimia nervosa include an obsessive attitude towards food and eating, an overcritical attitude to their weight and shape, and frequent visits to the bathroom after eating, after which the person might appear flushed and have scarred knuckles (from forcing fingers down the throat to bring on vomiting).

Bulimia can eventually lead to physical problems associated with poor nutrient intake, excessive vomiting or overuse of laxatives. Read more about these complications of bulimia.

Who is affected by bulimia nervosa?

As with all eating disorders, women are much more likely to develop bulimia than men.

However, bulimia nervosa is becoming increasingly common in boys and men. There are an estimated 1.6 million Britons suffering from some form of eating disorder, and reports estimate that up to 25% may be male.

Recent studies suggest that as many as 8% of women have bulimia at some stage in their life. The condition can occur at any age, but mainly affects women aged between 16 and 40 (on average, it starts around the age of 18 or 19).

Bulimia nervosa can affect children, but this is extremely rare.

What to do

If you have an eating disorder such as bulimia, the first step is to recognise that you have a problem. Then, you need to visit your GP for a medical check-up and advice on how to get treatment.

If you think someone you know has bulimia nervosa, talk to them and try to persuade them to see their GP.

There are also many support groups and charities you can approach for help, including:

The first step towards getting better is to recognise the problem and to have a genuine desire to get well.

There is strong evidence that self-help books can be effective for many people with bulimia nervosa, especially if they ask a friend or family member to work through it with them.

If this is not suitable or is unsuccessful, your GP can refer you for treatment to an eating disorder service, where you may be offered a structured programme of cognitive behavioural therapy (CBT). Some people may also benefit from antidepressant medication (fluoxetine), as this can reduce the urges to binge and vomit.

Bulimia nervosa

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Learn about bulimia nervosa, including how to spot the symptoms and how the eating disorder impacts on a person's life.

Media last reviewed: 22/04/2015

Next review due: 22/04/2017

NICE guidelines

The National Institute for Health and Care Excellence (NICE) has issued guidance to the NHS on eating disorders. It is mainly aimed at people with eating disorders, but the information may also be helpful for family members and those who care for people with eating disorders.

The NICE guidelines contain information on:

caring for someone with an eating disorder

what you can expect from the NHS if you have an eating disorder

support and treatment if you have bulimia nervosa

support and treatment if you have anorexia nervosa

support and treatment if you have another type of eating disorder, including binge eating